The purpose of the proposed rule is to add language incorporating the licensing fee, and include provisions increasing the length of time a license is active from one year to two years. The effect will be the simplification of the regulatory ...

 

DEPARTMENT OF CHILDREN AND FAMILIES

Mental Health Program

RULE NO.:RULE TITLE:

65E-9.003Licensure

PURPOSE AND EFFECT: The purpose of the proposed rule is to add language incorporating the licensing fee, and include provisions increasing the length of time a license is active from one year to two years. The effect will be the simplification of the regulatory process and a decrease in the administrative burden for entities licensed to operate a residential treatment center.

SUMMARY: Section 394.875, F.S., directs the Department, in consultation with the agency, to adopt rules governing a residential treatment center for children and adolescents which specify licensure standards. The anticipated revisions to the licensure rule will update the licensing fees to cover the agency’s costs associated with the licensing process, pursuant to Section 408.805, F.S. To align with Section 408.808(1), F.S., anticipated revisions will increase the length of time a license is active from one to two years. Lastly, removal of language duplicative of language found in statute simplifies the regulatory process.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION: The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: Preliminary staff analysis of this rule amendment indicates a minimal change in current regulatory cost impact.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 394.875(8) FS.

LAW IMPLEMENTED: 394.875 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 2 days before the workshop/meeting by contacting: Denise Barber, SAMH Program Information Unit, 1317 Winewood Boulevard, Building 6, Tallahassee, Florida 32399-0700, [phone], [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Krystle Cacci, Policy Analyst, [phone], [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

65E-9.003 Licensure.

(1) An entity operating that holds itself out to be or acts as a residential treatment center, including therapeutic group homes, shall first obtain a license annually and maintain active licensure from the Agency agency, unless specifically excluded from being licensed under the provisions of Section 394.875(5), F.S. Compliance with Chapter 394, Part I, 408, Part II, and Subsection 409.1678(3), F.S. shall be a condition of licensure. Application for licensure shall be made to the Agency on AHCA Form 3180-5004, February 2015, Health Care Licensing Application Residential Treatment Center for Children and Adolescents, which is incorporated by reference and available online at http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/rtc.shtml.

(2) Buildings that are separated from one another in which a similar level of residential care and treatment is provided may be licensed as one facility under the following circumstances:

(a) Such buildings are not separated by another building, part of a building, or buildings used for other purposes; and

(b) Such buildings are not separated by obstructions that impede the rapid movement of staff between them.

(3) License fee. An application fee of $240 per bed shall accompany be submitted with the an initial license application, change of ownership licensed operator application, and license with the annual renewal application. The fee is $115 per bed annually. For capacity changes effective during the license period, a $25 license reprint fee applies. increases, In addition, the application fee for capacity increases shall be the per bed fee for each additional bed to be added to the license. A per bed fee is not required for a capacity reduction unless the agency must make an on site visit to the facility. All fees are non-refundable. The fee shall be reasonably calculated annually and adjusted by the agency to cover the cost of regulation.

(4) Accredited Programs. Programs accredited by The Joint Commission (TJC), Commission on Accreditation of Rehabilitation Facilities, (CARF), Council on Accreditation (COA), or National Committee for Quality Assurance (NCQA) shall provide proof of accreditation as required by Section 394.741, F.S. Application for licensure by accredited programs does not preclude monitoring by the department or managing entity under contract with the department, the Agency, county public health unit, local fire authority having jurisdiction and fire marshal, nor compliance with the provisions of these rules.

(5)(4) Initial license – New construction, new operation, or reapplication of an expired license. change of licensed operator. Applicants for an initial license shall submit AHCA Form 3180-5004, “Residential Treatment Centers for Children and Adolescents,” dated June 2008 which is incorporated by reference and may be obtained from the agency. The application must be submitted to the agency at least 60 days prior to the date the facility would be available for inspection. The applicant shall provide all the information required by Chapter 408, Part II, Sections 394.875, and 394.876, F.S., and Chapter 59A-35, F.A.C. any other information determined to be needed by the agency. The application shall be under oath and must be accompanied by the appropriate license fee in order to be accepted and considered timely. The following additional documentation information shall be submitted with the application:

(a) Proof of compliance with Sections 394.4572 and 408.809, F.S. The name and mailing address of the applicant, and each person or entity controlling five percent or more interest in the corporation.

(b) Proof of liability insurance coverage from an authorized insurer in an amount no less than $300,000 per occurance with a minimal annual aggregate of no less than $1,000,000. The name, address, and federal employer identification number or taxpayer identification number of the applicant and each person or entity controlling five percent or more interest in the corporation.

(c) HIV/AIDS affidavit assuring required facility staff will be trained (see Section 381.0035, F.S.). The licensed name by which the provider is to be known.

(d) Copy of a satisfactory fire safety inspection report completed within the last 365 days by the local fire authority having jurisdiction or the local fire marshal. The total number of beds or capacity requested, as applicable.

(e) Copy of a satisfactory sanitation inspection report completed within the last 365 days by the local county public health unit. The street address, mailing address, telephone number, facsimile number, and any e-mail address of the provider for which application is made.

(f) Proof that the business registration is active with the Florida Department of State, Division of Corporations. The name of the administrator and financial officer. The name and telephone number of a contact person should be provided for questions regarding the application.

(g) Proof of the right to occupy the premises. Proof may be a warranty deed, lease agreement, quit claim deed, or similar document that confirms the applicant’s right to operate at the street address on the application form. The following additional documentation shall be submitted with the application:

1. Fiscal information including a current balance sheet and a statement of operations projecting revenues, expenses, taxes, extraordinary items, and other credits and charges for the first six months of operation to determine the ability of the applicant to carry out its financial responsibilities;

2. Proof of liability insurance coverage from an authorized insurer in an amount no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000;

3. Affidavit of compliance with Section 394.4572, F.S.

4. Affidavit of compliance with Section 381.0035, F.S.

5. Copy of a satisfactory fire safety inspection report completed within the last 365 days by the local fire authority having jurisdiction or the local fire marshal.

6. Copy of a satisfactory sanitation inspection report completed within the last 365 days by the local county public health unit.

7. Proof of the right to occupy the premises. Proof may be a warranty deed, lease agreement, quit claim deed, or similar document that confirms the applicant’s right to operate at the street address on the application form.

8. Proof that the corporation is active with the Florida Department of State, Division of Corporations. Proof may be a copy of a current certificate of status issued by the Division of Corporations or a copy of the corporation's completed annual report form and a copy of both sides of the cancelled check submitted for payment of the corporation's renewal fee.

(h)9. Facilities that would be considered a community residential home under Chapter 419, F.S., who are being licensed for the first time or existing facilities that have changed location or ownership shall provide a completed, “Community Residential Home Affidavit of Compliance with Chapter 419 Form,” dated February 2010 August 2006 which is incorporated by reference and may be obtained from the agency’s website http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/forms/CommResHome_AffidavitofComplianceWithCh419.pdf. http://ahca.myflorida.com/MCHQ/Long_Term_Care/Assisted_living/afc/CRH_InterimAffidavit%20_afch _3.pdf. All For all other residential treatment centers, being licensed for the first time or who have changed location or ownership shall provide a report or letter from the zoning authority dated within the last six months indicating the street location is zoned appropriately for its use.

10. A copy of the center’s occupational license.

(5) Accredited Programs. Programs accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), CARF – The Rehabilitation Accreditation Commission, Council on Accreditation (COA), or National Committee for Quality Assurance (NCQA) shall provide proof of accreditation as required by Section 394.741, F.S. Application for licensure by accredited programs does not preclude monitoring by the department, the AHCA, county public health unit, local fire authority having jurisdiction and fire marshal, and compliance with the provisions of these rules.

(6) New Programs. A newly developing program may be provided a 90-day probationary license when the application has been verified for compliance with applicable statutes and rules. The probationary period may be extended for an additional 90 days if the applicant has substantially complied with the requirements for licensure and if action has been initiated to satisfy all requirements of applicable statutes and rules. When it is determined that the facility is endangering the health and safety of persons receiving services, the probationary license will be cancelled by the AHCA.

(6)(7) Renewal License Renewal. An applicant for license renewal must submit a complete application package that meets the requirements of Section 408.806, F.S. and Rule 59A-35.060, F.A.C. The following additional documentation shall be submitted with the application:

(a) All applications, fees, and supporting materials for licensure shall be provided to the AHCA 60 days before the expiration of the existing license.

(b) All applicants shall submit an application AHCA Form 3180-5004, dated 1/2008, “Residential Treatment Centers for Children and Adolescents Application”, which is incorporated by reference, which is provided by AHCA. The application is available on the agency’s web site at http://www.acha.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/ index.shtml. The application shall include all information required by Sections 394.875 and 394.876, F.S., and any other information determined to be needed by the agency;

(c) The information required by paragraphs (4)(a) through (g) of this section; and

(d) For accredited facilities accredited by an accrediting organization listed in Rule 65E-9.003(4), provide a copies of any correspondence to or from the accrediting organization that have not been submitted previously to the agency since the current accreditation was awarded. A copy of the current accreditation report. The accreditation report shall include any citations to which the accrediting organization requires a response, the facility’s response to each citation and the accreditation award letter., accreditation certificate, and The accreditation report must be submitted only if a new accreditation period has been awarded since the initial application or last renewal application was filed with the agency.

(8) Failure to apply for the renewal of a license prior to the expiration date renders the license null and void and the former licensee may not be issued another license until the corporation applies for a new initial license and meets all current qualifications for licensure, including zoning, construction standards, and fire safety standards, where applicable.

(7)(9)(a) Change of ownership. An applicant for initial licensure due to a change of licensed operator must submit a complete application package at least 60 days prior to the date of the anticipated change of licensed operator.

(a)(b) An applicant for initial licensure due to a change of ownership must submit a complete application package that meets the requirements of Sections 408.806 and 408.807, F.S. and Rule 59A-35.060 and 59A-35.070, F.A.C. The transferor shall be responsible and liable for:

(b) The Agency will process the change of ownership application according to the requirements of Chapter 408, Part II , F.S. and Rule 59A-35, F.A.C.

(c) The information required by paragraphs (5)(a) through (h) of this section shall be submitted with the application

(d) A copy of the closing documents, which must include an effective date and the signatures of both the buyer and the seller must be received by the Agency before a license will be issued.

1. The lawful operation of the facility until the date the transferee is licensed by the agency.

2. All penalties imposed against the facility for violations occurring before the date of the transfer of ownership unless the penalty imposed is a moratorium on admissions or denial of the license. The moratorium on admissions or denial of the license remains in effect after the transfer of ownership, unless the agency has approved the transferee’s corrective action plan or the conditions that created the moratorium or denial have been corrected, and may result in denial of license to the transferee in accordance with Chapter 120, F.S.

3. Any outstanding liability to the state, unless the transferee has agreed as a condition of sale or transfer to accept the outstanding liabilities and to guarantee payment therefore; except that, if the transferee fails to meet these obligations, the transferor shall remain liable for the outstanding liability and shall honor such liability by payment to the state prior to issuance of the new license or by executing such documents of indebtedness as the state shall require as a condition of this licensing process.

a. The transferor of a facility, the license of which is denied pending an administrative hearing, shall, as a part of the written transfer-of-licensed operator contract, advise the transferee that a plan of correction shall be submitted by the transferee and approved by the agency at least seven (7) days before the transfer of licensed operator and that failure to correct the condition which resulted in the moratorium on admissions or denial of the license shall be grounds for denial of the transferee’s license.

b. The transferee shall provide the agency with proof of legal right to occupy the property before a license may be issued. Proof may include copies of warranty deeds, or copies of a lease or rental agreement, contracts for deeds, quit claim deeds, or other such documentation satisfactory to the agency.

c. When the provider receives notification that the agency has determined that the application package for a change of licensed operator contains all required documentation and the required fee has been paid, a 90-day probationary license may be issued. The probationary period may be extended for an additional 90 days if the applicant has substantially complied with the requirements for licensure, and if action has been initiated to satisfy all of the remaining requirements.

(8)(10) For any other application or request, the applicant must submit an the application or request at least 60 days prior to the requested effective date. that meets the requirements of Sections 408.806, and 408.807, F.S. and Rules 59A-35.060 and 59A-35.070, F.A.C. The Agency will process the application according to the requirements of Chapter 408, Part II, F.S. and Rule 59A-35, F.A.C.

(11) Upon receipt of an application for a license, the agency shall examine the application and, within 30 days after receipt, notify the applicant of any apparent errors or omissions and request any additional information required. Requested information omitted from an application for licensure, license renewal, capacity increase, capacity decrease, or change of licensed operator must be filed with the agency within 21 days after the agency’s request for omitted information, or the application shall be deemed incomplete, shall be withdrawn from further consideration, and the fees forfeited.

(9)(12) The failure to file a timely application and license fee shall result in a late fee charged to the licensee as authorized under Section 408.806 394.879(4), F.S.

(13) Within 60 days after the receipt of a complete application package, the agency shall:

(a) Approve or deny the application; or

(b) Authorize an inspection be conducted, if required by Section 394.90, F.S.

(14) Each license issued shall indicate the name of the licensee, the type of license issued, type of service that the licensee is required or authorized to operate or offer, the effective date of the license, the expiration date of the license, the maximum capacity of the licensed premises, and any other information required or deemed necessary by the agency.

(10)(15) The license shall be displayed in a conspicuous location inside the facility.

(11)(16) Program Closure. If the licensee voluntarily closes the facility, the licensee shall notify the department and the Agency AHCA in writing at least 30 90 days prior to such closure. The program which is closing, with the assistance of the department, managing entity under contract with the department, Medicaid managed care plan and the Agency AHCA, shall attempt to relocate place all persons receiving services, with their valid lawful consent, in other programs to which respective clinical records shall be transferred at the time the resident is relocated. The licensee shall notify the Agency AHCA, and the department and the managing entity under contract with the department where the files of previously discharged residents will be stored.

(12)(17) Program Closure Following Receivership Proceedings. By accepting a license under this chapter, the licensee agrees to cooperate with the department and the AHCA in accepting the adversely affected individuals when closure of a program follows receivership proceedings as defined in Section 394.903, F.S.

(13)(18) Enforcement of these rules shall be in accordance with Sections 394.879 and 394.902, F.S.

Specific Authority 394.875(8) FS. Law Implemented 394.875, 394.903, 409.1678, FS. History–New 7-25-06, Amended 9-24-08,___________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Krystle Cacci, Policy Analyst

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Mike Carroll, Secretary, Florida Department of Children and Families

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: March 4, 2015

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: March 10, 2015